Including patients as key players on their health care team could produce better health management, especially among patients with chronic diseases or at risk of developing them, according to a new discussion paper from the Institute of Medicine.
The discussion paper, released last week, examines the enhancements in care that can come from including patients and families as active participants in their health care teams. Studies show that results are better, readmission rates are lower, patients’ satisfaction ratings are higher, and costs can drop when patients and family caregivers are fully involved in making care decisions and executing health care practices.
“Patient and family caregivers share insights and context about their needs, goals, preferences and experiences in collaboration with health providers who, in turn, contribute their clinical knowledge and expertise,” the paper said. “Each member of the team is encouraged to bring a unique perspective into a continuously learning health care partnership.”
Patient engagement is a crucial part of the hypertension work underway as part of the AMA’s Improving Health Outcomes initiative, a collaboration with Johns Hopkins Medicine. Physicians and care teams participating in this pilot in Maryland and Illinois are working to bring patients’ high blood pressure under control by using the “M.A.P. framework” (log in).
The M.A.P. is based on three concepts:
- Measure accurately
- Act rapidly
- Partner with patients to promote patient self-management
Along with making clinical changes to address the M.A.P., the pilot practices are establishing clinical-community linkages, in which physicians refer patients to community resources that can help them improve their blood pressure. The practices also are testing different ways to maintain contact with patients outside of office visits and empowering patients to take control of their blood pressure.
For example, a Chicago-area physician has implemented a strong home-monitoring program for patients whose blood pressure management requires more clinical data. Practice staff give these patients a special checklist that explains how to properly position themselves for measurement as well as when and how often they should be measuring their blood pressure.
The staff then validates and checks the accuracy of patients’ personal blood pressure machines or lends patients machines that record a week’s worth of blood pressure readings. Through this approach, coupled with team-based care, the practice has achieved a 90 percent control rate for hypertension patients.
The AMA/Johns Hopkins initiative also is engaging patients at a higher level with the launch of a Patient and Family Advisors Council. Five patients with personal connections to high blood pressure and its effects on health are working with the AMA and its partners to ensure the patient perspective is represented in new tools and ideas.
“Patients want to feel they are listened to by their providers, cared for and about, and invited to participate to the extent they desire,” the IOM paper said. “[They] value effective team-based care that treats them as whole persons, not cases, conditions or diseases.”
